| NPI | 1114455102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 287344) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 271599) |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2021-09-02 |